U.S. patent application number 13/493104 was filed with the patent office on 2012-10-04 for "teach and repeat" method and apparatus for physiotherapeutic applications.
This patent application is currently assigned to HEADWAY LTD.. Invention is credited to Tamir LEVITAL, Yaron Moshe RIVER.
Application Number | 20120253241 13/493104 |
Document ID | / |
Family ID | 44166822 |
Filed Date | 2012-10-04 |
United States Patent
Application |
20120253241 |
Kind Code |
A1 |
LEVITAL; Tamir ; et
al. |
October 4, 2012 |
"TEACH AND REPEAT" METHOD AND APPARATUS FOR PHYSIOTHERAPEUTIC
APPLICATIONS
Abstract
The present invention provides a device for controlling a
physical therapy device adapted for accepting external commands,
comprising: a. a moveable portion of substantially the same shape
and dimensions as that portion of said physical therapy device that
is adapted for interacting with at least one part of the body of a
patient; b. a base; c. a motion manipulation portion d. conversion
means for converting said stored time-dependent output signals to a
series of command signals; and, e. means for transmitting said
command signals to said physical therapy device; wherein a series
of command signals are produced by the movement of said moveable
portion, which, when transmitted to said physical therapy
apparatus, will cause said physical therapy apparatus to undergo a
series of motions substantially identical to those of said moveable
portion.
Inventors: |
LEVITAL; Tamir; (Ramat Gan,
IL) ; RIVER; Yaron Moshe; (Qiryat Tivon, IL) |
Assignee: |
HEADWAY LTD.
Misgav
IL
|
Family ID: |
44166822 |
Appl. No.: |
13/493104 |
Filed: |
June 11, 2012 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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PCT/IL2010/001070 |
Dec 16, 2010 |
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13493104 |
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61287199 |
Dec 17, 2009 |
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Current U.S.
Class: |
601/5 |
Current CPC
Class: |
A61H 2230/60 20130101;
A61H 2230/65 20130101; A61H 2230/06 20130101; A61H 2201/5084
20130101; A61H 2230/10 20130101; A61H 2230/30 20130101; A61H
2201/018 20130101; A61H 2201/5064 20130101; A61H 2201/5097
20130101; A61H 2201/1659 20130101; A61H 2203/0456 20130101; A61H
2201/5079 20130101; A61H 2203/0468 20130101; A61H 2201/5038
20130101; A61H 2201/02 20130101; A61H 2201/5048 20130101; A61H
1/0296 20130101 |
Class at
Publication: |
601/5 |
International
Class: |
A61H 1/02 20060101
A61H001/02 |
Foreign Application Data
Date |
Code |
Application Number |
Dec 16, 2010 |
IL |
PCT/IL2010/001070 |
Claims
1. A device for controlling a physical therapy device adapted for
accepting external commands, said device comprising: a. a moveable
portion adapted for interacting with at least one part of the body
of a patient; b. a base; c. a motion manipulation portion in
communication with said moveable portion and said base, said motion
manipulation portion comprising: i. a plurality of sensors adapted
for making time-dependent measurements of at least one of (a)
direction of motion, (b) velocity, and (c) acceleration of said
moveable portion along each degree of freedom of its motion; ii.
means for converting each of said time-dependent measurements into
at least one time-dependent output signal proportional to said
measurement; and, iii. means for transmitting each of said at least
one time-dependent output signals to a transceiver; d. a
transceiver adapted for receiving each of said at least one
time-dependent output signals and transmitting each of said at
least one time-dependent output signals to a storage means; e.
storage means adapted for storing said time-dependent output
signals transmitted from said transceiver; f. conversion means for
converting said stored time-dependent output signals to a series of
command signals; and, g. means for transmitting said command
signals to said physical therapy device; wherein a series of
command signals are produced by the movement of said moveable
portion, which, when transmitted to said physical therapy
apparatus, will cause said physical therapy apparatus to undergo a
series of motions substantially identical to those of said moveable
portion.
2. The device of claim 1, wherein said moveable portion comprises a
plurality of sensors selected from a group consisting of
accelerometers, inclinometers, gyroscopic, ultrasound sensors,
adapted to determine the position of at least one part of the body
of a patient.
3. The device of claim 1, wherein at least one of said sensors are
selected from a group consisting of stereoscopic (3D) cameras
adapted for motion detection, image capture equipment adapted for
tracking and recording motion or any combination thereof.
4. The device of claim 1, additionally comprising at least one
selected from a group consisting of (a) means adapted to maintain
said patient in a predetermined position on a treatment table; (b)
connecting means adapted for connecting one end of said motion
manipulation portion to said moveable portion are further adapted
such that linear motions of said moveable portion retain three
degrees of freedom; (c) connecting means adapted for connecting one
end of said motion manipulation portion to said moveable portion
are further adapted such that rotational motions of said movable
portion retain three degrees of freedom; and any combination
thereof.
5. The device of claim 1, wherein at least one of the following is
being held true (a) said transceiver is a control card adapted for
receiving signals from said at least one sensor; (b) said storage
means is a digital storage means; (c) said means for transmitting
each of said at least one time-dependent output signals is chosen
from the group consisting of (a) hardwired, (b) wireless; (d) said
means for transmitting each of said command signals is chosen from
the group consisting of (a) hardwired, (b) wireless; and any
combination thereof.
6. The device of claim 1, further comprising a computer and
software adapted to allow a user to recall said signals from
storage and to transmit said command signals to said physical
therapy apparatus a predetermined number of times with a
predetermined frequency or varied by a predetermined coefficient;
further comprising an interface and software adapted to allow
direct input of information and conversion of at least a part of
said information to time-dependent command signals.
7. The device of claim 1, further comprising means for measuring
and reporting at least one parameter related to the medical,
physiological, or emotional status of a patient; further wherein
said at least one parameter related to the medical, physiological,
and/or emotional status of a patient is chosen from the group
consisting of (a) EMG, (b) ROM, (c) blood pressure, (d) EKG, (e)
galvanic skin response (GSR), and (f) any combination of the
above.
8. The device of claim 7, wherein at least one of the following is
being held true (a) said reporting is provided to at least one
module chosen from the group consisting of (a) adjacent to said
physical therapy apparatus, (b) remote from said physical therapy
apparatus; (b) said device further comprising an interface between
said detecting and said reporting means and said means for
transmitting command signals to said physical therapy device; (c)
said device further comprising means selected from mechanical,
software or hardware for limiting by a predetermined amount at
least one motion of said physical therapy device to a value lower
than the analogous motion of said moveable part for at least part
of the time during which at least one of said parameters related to
the medical, physiological, and/or emotional status of a patient is
within a predetermined set of values relative to a predetermined
set of boundary conditions; (d) said device further comprising
means for increasing by a predetermined amount at least one motion
of said physical therapy device above the value of the analogous
motion of said moveable part for at least part of the time during
which at least one of said parameters related to the medical,
physiological, and/or emotional status of a patient is within a
predetermined set of values relative to a predetermined set of
boundary conditions; and any combination thereof.
9. The device of claim 1, further comprising means for determining
in real time the position and orientation of the body of a patient
or at least one part thereof, said means chosen from the group
consisting of (i) a camera system adapted for determining and
reporting in real time the 3D position and orientation of an object
such that said determination is provided by means of image
processing; and (ii) a plurality of sensors adapted to measure and
report their positions in real time attached to at least one
selected from (a) said body of a patient or a part thereof; (b) the
caregiver's hands while tailoring the treatment course; (b) said
moveable portion; wherein said time-dependent output signal is
proportional to the time-dependent position and orientation and
position of said body of a patient, caregiver or movable portion,
or a least one part thereof; further wherein at least one of said
sensors are selected from a group consisting of stereoscopic (3D)
cameras adapted for motion detection, image capture equipment
adapted for tracking and recording motion or any combination
thereof.
10. The device of claim 1, wherein said motions are selected from
said allowed movements; further wherein said motions are selected
according to parameters characterizing said patient; said
parameters are selected from a group consisting of any combination
of physiological movements, in the sagittal (flexion-extension),
coronal (right and left lateral banding) and horizontal (right and
left rotation).
11. A method for controlling a physical therapy apparatus adapted
for receiving external commands, said method comprising steps of:
a. obtaining the device of claim 1; b. moving said moveable portion
according to a predetermined protocol; c. measuring the
time-dependent positions of said moveable portion during the course
of said predetermined protocol; d. converting said measurements to
a time-dependent signal; e. transmitting said time-dependent signal
to said transceiver; f. storing said time-dependent signal by using
said storage means; g. converting said time-dependent signal to a
time-dependent command signal; and, h. transmitting said
time-dependent command signal to said physical therapy apparatus;
wherein moving said moveable portion causes said physical therapy
apparatus to undergo a series of motions substantially identical to
those of said moveable portion.
12. The method of claim 11, further comprising steps of: a.
recalling said time-dependent signal from said storage means; b.
converting said recalled time-dependent signal to a time-dependent
command signal; and, c. transmitting said time-dependent command
signal to said physical therapy apparatus; and, d. repeating steps
(i) through (k) a predetermined number of times.
13. The method of claim 11 adapted for transmitting at least one
signal proportional to its orientation and further adapted for
receiving external commands; said method further comprising steps
of: a. manually altering the orientation of said physical therapy
apparatus according to a predetermined protocol; b. transmitting,
during the course of said predetermined protocol, at least one
time-dependent signal proportional to the orientation of said
physical therapy apparatus to a storage device adapted for storing
time-dependent signals; c. storing said at least one transmitted
time-dependent signal in said storage device; d. recalling said
time-dependent signal from said storage device; e. converting said
recalled time-dependent signal to a time-dependent command signal;
f. transmitting said time-dependent command signal to said physical
therapy apparatus; and, g. repeating steps (d) through (f) a
predetermined number of times; wherein transmitting said command
signal causes said physical therapy apparatus to undergo
substantially the same motions produced by said predetermined
protocol.
14. The method of claim 13, comprising the additional step of
placing at least one body part in a position such that said
alterations in the orientation of said physical therapy apparatus
will manipulate said at least one body part according to a
predetermined protocol; further wherein said additional step of
placing at least one body part in a position such that said
alterations in the orientation of said physical therapy apparatus
will manipulate said at least one body part according to a
predetermined protocol occurs after step (c) and prior to step
(d).
15. The method of claim 13, additionally comprising step of
maintaining said patient in a predetermined position on a treatment
table.
16. A method for controlling a physical therapy apparatus adapted
for receiving external commands, said method comprising steps of:
a. obtaining an apparatus adapted for determining the
time-dependent position and orientation of at least one body part
of a subject and further adapted for transmitting a time-dependent
signal proportional to said time-dependent position and
orientation; b. altering the position of said at least one body
part according to a predetermined protocol; c. measuring the
time-dependent position and orientation of said at least one body
part using said apparatus during the performance of said
predetermined protocol; d. transmitting a time-dependent signal
proportional to the time-dependent position and orientation of said
at least one body part during the performance of said predetermined
protocol from said apparatus to a storage device; e. recalling said
time-dependent signal from said storage device; f. converting said
time-dependent signal to a time-dependent command signal; g.
transmitting said time-dependent command signal to said physical
therapy apparatus; and, h. repeating steps (e) through (g) a
predetermined number of times; wherein said command signal produces
a series of alterations of the orientation of said physical therapy
apparatus substantially identical to those necessary to manipulate
the position and orientation of said at least one body part
according to said predetermined protocol.
17. The method according to claim 16, wherein at least one of the
following is being held true (a) said step of obtaining an
apparatus adapted for determining the time-dependent position and
orientation of at least one body part of a subject and further
adapted for transmitting a time-dependent signal proportional to
said time-dependent position and orientation further includes a
step of obtaining a camera system adapted for determining and
reporting in real time the 3D position and orientation of an object
by means of image processing; (b) said method additionally
comprising step of maintaining said patient in a predetermined
position on a treatment table; (c) said method additionally
comprising step of selecting at least one of said sensors from a
group consisting of stereoscopic (3D) cameras adapted for motion
detection, image capture equipment adapted for tracking and
recording motion or any combination thereof.
18. The method according to claim 16, wherein said step of
obtaining an apparatus adapted for determining the time-dependent
position and orientation of at least one body part of a subject and
further adapted for transmitting a time-dependent signal
proportional to said time-dependent position and orientation
further includes the additional steps of a. obtaining a plurality
of sensors adapted to measure and report their positions in real
time; and, b. attaching said plurality of sensors to said at least
one body part of a subject.
19. The method of claim 16, additionally comprising step of
maintaining said patient in a predetermined position on a treatment
table.
20. The method of claim 16, additionally comprising step of
selecting at least one of said sensors from a group consisting of
stereoscopic (3D) cameras adapted for motion detection, image
capture equipment adapted for tracking and recording motion or any
combination thereof.
21. The method according to claim 16, further comprising the
additional steps of: a. measuring at least one parameter related to
the medical, physiological, and/or emotional status of a patient;
b. reporting said at least one parameter related to the medical,
physiological, and/or emotional status of a patient; and c.
limiting by a predetermined amount at least one motion of said
physical therapy device to a value lower than the analogous motion
of said moveable part for at least part of the time during which at
least one of said parameters related to the medical, physiological,
and/or emotional status of a patient is within a predetermined set
of values relative to a predetermined set of boundary
conditions.
22. The method according to claim 16, further comprising the
additional steps of: a. measuring at least one parameter related to
the medical, physiological, and/or emotional status of a patient;
b. reporting said at least one parameter related to the medical,
physiological, and/or emotional status of a patient; c. limiting by
a predetermined amount at least one motion of said physical therapy
device to a value lower than the analogous motion of said moveable
part for at least part of the time during which at least one of
said parameters related to the medical, physiological, and/or
emotional status of a patient is within a predetermined set of
values relative to a predetermined set of boundary conditions; and
d. increasing by a predetermined amount at least one motion of said
physical therapy device above the value of the analogous motion of
said moveable part for at least part of the time during which at
least one of said parameters related to the medical, physiological,
and/or emotional status of a patient is within a predetermined set
of values relative to a predetermined set of boundary
conditions.
23. The method according to claim 16, further comprising the
additional steps of: a. obtaining a voice recognition unit; b.
interfacing said voice recognition unit with said means for
transmitting a command signal to said physical therapy device; c.
receiving a vocal command; and, d. performing at least one function
chosen from the group consisting of (a) initiate a therapy session;
(b) terminate a therapy session; (c) override said time-dependent
command signals; (d) limit at least one motion of said physical
therapy device; (e) extend at least one motion of said physical
therapy device; and (f) any combination of the above.
24. The method according to claim 16, further comprising at least
one additional step selected from a group consisting of (a) playing
music during at least a portion of the time that said physical
therapy apparatus is in use; (b) displaying a virtual reality
simulation during at least a portion of the time that said physical
therapy apparatus is in use; (c) maintaining said patient in a
predetermined position on a treatment table; and any combination
thereof.
25. An apparatus for providing physical therapy and treating the
body of a patient or a part thereof (the treated part), by
controllably maneuvering said treated organ, said apparatus
comprising: a. a cradle adapted for holding said treated part
stably and comfortably; and, b. a maneuverable platform upon which
said cradle rests, comprising maneuvering means adapted for
rotating the platform in the sagittal, coronal, horizontal planes
or in any combination of the planes thereof for a predetermined
duration; c. controlling means adapted to control said physical
therapy by accepting external commands, in communication with said
maneuvering means; said controlling means comprising: i. a moveable
portion adapted for interacting with at least one part of the body
of a patient; ii. a base; iii. a motion manipulation portion in
communication with said moveable portion and said base, said motion
manipulation portion comprising: a. a plurality of sensors adapted
for making time-dependent measurements of at least one of (a)
direction of motion, (b) velocity, and (c) acceleration of said
moveable portion along each degree of freedom of its motion; b.
means for converting each of said time-dependent measurements into
at least one time-dependent output signal proportional to said
measurement; and, c. means for transmitting each of said at least
one time-dependent output signals to a transceiver; iv. a
transceiver adapted for receiving each of said at least one
time-dependent output signals and transmitting each of said at
least one time-dependent output signals to a storage means; v.
storage means adapted for storing said time-dependent output
signals transmitted from said transceiver; vi. conversion means for
converting said stored time-dependent output signals to a series of
command signals; and, vii. means for transmitting said command
signals to said controlling means; wherein said maneuver of said
part is characterized by parameters selected from a predetermined
set of allowed movements; further wherein a series of command
signals are produced by the movement of said moveable portion,
which, when transmitted to said physical therapy apparatus, will
cause said physical therapy apparatus to undergo a series of
motions substantially identical to those of said moveable
portion.
26. The apparatus of claim 25, wherein said moveable portion
comprises a sensors selected from a group consisting of
accelerometers, inclinometers, gyroscopic, ultrasound sensors,
adapted to determine the position of at least one part of the body
of a patient.
27. The apparatus of claim 25, wherein said moveable portion of
substantially the same shape and dimensions as that portion of said
physical therapy.
28. The apparatus of claim 25, wherein at least one of the
following is being held true (a) at least one of said sensors are
selected from a group consisting of stereoscopic (3D) cameras
adapted for motion detection, image capture equipment adapted for
tracking and recording motion or any combination thereof; (b) said
apparatus additionally comprising means adapted to maintain said
patient in a predetermined position on a treatment table; (c) said
treated part is chosen from the group consisting of (a) head, (b)
neck, (c) any combination of the above; (d) said treated part is
maneuvered in a lobular three dimensional manner; and any
combination thereof.
29. The apparatus of claim 25, additionally comprising at least one
selected from a group consisting of (a) processing means for either
online or offline controlling or determining said parameters; (b)
means for presenting audiovisual entertainment during the use of
said apparatus, said means for presenting audiovisual entertainment
chosen from the group consisting of (i) means for playing music
during the treatment, (ii) means for presenting a virtual reality
display; (c) at least one detecting means and reporting means
chosen from the group consisting of EMG, EKG, GSR or a combination
thereof, said at least one detecting means and reporting means
adapted to obtain one or more parameters related to the medical,
physiological, and/or emotional condition of said patient; said
reporting means further adapted for either online or offline
reporting of said condition of said patient, and said reporting
means adapted to provide a report to at least one of (a) a remote
module, (b) an adjacent module; wherein said at least one detecting
means is feedback interconnected with said maneuverable platform
such that at least a portion of said maneuvering parameters is
updated in a manner chosen from the group consisting of (a) online
and (b) offline.
30. The apparatus of claim 25, wherein said motions are selected
from said allowed movements; further wherein said motions are
selected according to parameters characterizing said patient; said
parameters are selected from a group consisting of any combination
of physiological movements, in the sagittal (flexion-extension),
coronal (right and left lateral banding) and horizontal (right and
left rotation).
Description
FIELD OF THE INVENTION
[0001] The present invention generally relates to means controlling
for physiotherapy devices, in particular, for directing motions of
devices designed to treat, control, or prevent skeletal or
musculoskeletal pain.
BACKGROUND OF THE INVENTION
[0002] An important salient feature of chronic head and neck pain
syndromes is muscle dysfunction. Whatever the origin of pain
(trauma, pathology of the cervical spine, etc.), patients
frequently develop lateral, anterior and posterior neck muscle
activation imbalance, muscle fatigue, muscle shortening, and
over-contraction of agonist and antagonist muscles. Subsequently,
muscle hyperalgesia and reduced neck range of motion is induced.
This hyperalgesia is a part of a vicious cycle of pain mechanism.
Mobilization and/or physical therapy are effective for some
patients, whereas for other patients, biofeedback relaxation
techniques are helpful. In many cases, the therapeutic protocol
involves a set of motions that are repeated cyclically. A number of
devices have been developed that are designed to provide at least
some degree of automation to the therapeutic protocol.
[0003] U.S. Pat. No. 5,320,641 discloses a device for spinal
rehabilitation, allowing a limited elevation/depression of
different parts of the spinal column, not necessarily the cervical
spine. The device allows only one degree of freedom, no true
feedback from the patient. It mainly relates to post operative
treatment and not for the treatment of headache and/or neck pain.
It is mainly focused on enlarging the flexion/extension range of
movement of the neck post trauma, post surgery.
[0004] Japanese Pat. No. 5,038,307 describes a seat for a vehicle
having variable air pressure mats within. Electromyograph signals
are taken of the driver's body. When these signals indicate that
the driver is tired, the air pressure of the seat is varied.
However this variation is not intended to relax the driver but
rather to increase his level of alertness while driving. The
pattern of inflation is therefore not adapted to decrease the
electromyographic potentials indicating muscle tension by use of
feedback. Since the head and neck are not specifically stimulated
by this cradle, it is unlikely that the cradle is adapted to
provide relief from headaches or muscle tension. It does not
reposition the head and neck in a manner similar to physical
therapy adjustment. Finally, it does not determine the ideal degree
of movement for each individual, nor does it maintain a
computerized record of such.
[0005] U.S. Pat. No. 5,320,641 discloses a computer-controlled
physical therapy device. This device is designed for treatment of a
patient's back. It provides support for the back and the option of
providing a predetermined pivoting (axial) motion. The actuators
for the pivoting motion are computer controlled. This device makes
no provision for rotational motion of the patient, and changes in
the treatment protocol are performed by direct keyboard input to
the computer.
[0006] U.S. Pat. No. 5,578,060 discloses an interactive physical
therapy apparatus. This apparatus likewise provides for computer
control. An operator can input into the computer specific treatment
parameters, in particular, which body part is to be selected for
treatment.
[0007] There remains, however, a long-felt need for a physical
therapy system that permits input of treatment protocols (e.g. the
direction and duration of the motions of the treatment apparatus)
by means other than direct input of desired parameters; in which
the control system is able to provide a treatment protocol for
motions with six degrees of freedom (three translational and three
rotational); and which provides the option of true feedback, in
which the control apparatus modifies the treatment protocol
according to parameter's related to the state of the patient during
the course of the treatment.
SUMMARY OF THE INVENTION
[0008] The present invention is designed to meet this long-felt
need. It presents a physical therapy method and device in which the
manipulations of a patient's body or part thereof can be controlled
remotely by any one of a number of means. It also provides for
automation of the remote control, as well as for a variety of
feedback mechanisms by which the patient or caregiver can interact
with the system in real time to modify the original treatment
protocol.
[0009] It is therefore an object of the present invention to
disclose a device for controlling a physical therapy apparatus
adapted for accepting external commands, said device comprising:
(a) a moveable portion of substantially the same shape and
dimensions as that portion of said physical therapy apparatus that
is adapted for interacting with at least one part of the body of a
patient; (b) a base; (c) a motion manipulation portion, said motion
manipulation portion comprising: (i) connecting means adapted for
connecting one end of said motion manipulation portion to said
moveable portion; (ii) connecting means adapted for connecting the
other end of said motion manipulation portion to said base; (iii) a
plurality of sensors adapted for making time-dependent measurements
of at least one of (1) direction of motion, (2) velocity, and (3)
acceleration of said moveable portion along each degree of freedom
of its motion; (iv) means for converting each of said
time-dependent measurements into at least one time-dependent output
signal proportional to said measurement; and, (v) means for
transmitting each of said at least one time-dependent output
signals to a transceiver; (d) a transceiver adapted for receiving
each of said at least one time-dependent output signals and
transmitting each of said at least one time-dependent output
signals to a storage means; (e) storage means adapted for storing
said time-dependent output signals transmitted from said
transceiver; (f) conversion means for converting said stored
time-dependent output signals to a series of command signals; and
(g) means for transmitting said command signals to said physical
therapy device. It is within the essence of the invention wherein
moving said moveable portion produces a series of command signals,
which, when transmitted to said physical therapy apparatus, will
cause said physical therapy apparatus to undergo a series of
motions substantially identical to those of said moveable
portion.
[0010] It is a further object of this invention to disclose such a
device, wherein at least one of said sensors are selected from a
group consisting of stereoscopic (3D) cameras adapted for motion
detection, image capture equipment adapted for tracking and
recording motion or any combination thereof. It is a further object
of this invention to disclose such a device, additionally
comprising means adapted to maintain said patient in a
predetermined position on a treatment bed
[0011] It is a further object of this invention to disclose such a
device, wherein said connecting means adapted for connecting one
end of said motion manipulation portion to said moveable portion
are further adapted such that linear motions of said moveable
portion retain three degrees of freedom and rotational motions of
said movable portion retain three degrees of freedom.
[0012] It is a further object of this invention to disclose such a
device, wherein the cradle can mobilized by the caregiver and/or
the device to move the patient's head and neck in 3 planes of
movement (6 degrees of freedom); said degrees of freedom are
selected from a group consisting of 3 rotations, and 3
translations.
[0013] It is a further object of this invention to disclose such a
device, wherein said transceiver is a computer board adapted for
receiving signals from said at least one sensor.
[0014] It is a further object of this invention to disclose such a
device, wherein at least one of said sensors are selected from a
group consisting of stereoscopic (3D) cameras adapted for motion
detection, image capture equipment adapted for tracking and
recording motion or any combination thereof.
[0015] It is a further object of this invention to disclose such a
device, wherein said storage means is a digital storage means.
[0016] It is a further object of this invention to disclose such a
device, wherein said means for transmitting each of said at least
one time-dependent output signals is chosen from the group
consisting of (a) hardwired, (b) wireless.
[0017] It is a further object of this invention to disclose such a
device, wherein said means for transmitting each of said command
signals is chosen from the group consisting of (a) hardwired, (b)
wireless.
[0018] It is a further object of this invention to disclose such a
device as disclosed in any of the above, further comprising a
computer and software adapted to allow a user to recall said
signals from storage and to transmit said command signals to said
physical therapy apparatus a predetermined number of times with a
predetermined frequency.
[0019] It is a further object of this invention to disclose such a
device, further comprising an interface and software adapted to
allow direct input of information and conversion of at least a part
of said information to time-dependent command signals.
[0020] It is a further object of this invention to disclose such a
device as disclosed in any of the above, further comprising means
for measuring and reporting at least one parameter related to the
medical, physiological, or emotional status of a patient.
[0021] It is a further object of this invention to disclose such a
device, wherein said at least one parameter related to the medical,
physiological, and/or emotional status of a patient is chosen from
the group consisting of (a) EMG, (b) ROM, (c) blood pressure, (d)
EKG, (e) galvanic skin response (GSR), and (f) any combination of
the above.
[0022] It is a further object of this invention to disclose such a
device, wherein said reporting is provided to at least one module
chosen from the group consisting of (a) adjacent to said physical
therapy apparatus, (b) remote from said physical therapy
apparatus.
[0023] It is a further object of this invention to disclose such a
device, further comprising an interface between said detecting and
said reporting means and said means for transmitting command
signals to said physical therapy device.
[0024] It is a further object of this invention to disclose such a
device, further comprising means for limiting by a predetermined
amount at least one motion of said physical therapy device to a
value lower than the analogous motion of said moveable part for at
least part of the time during which at least one of said parameters
related to the medical, physiological, and/or emotional status of a
patient is within a predetermined set of values relative to a
predetermined set of boundary conditions.
[0025] It is a further object of this invention to disclose such a
device, further comprising means for increasing by a predetermined
amount at least one motion of said physical therapy device above
the value of the analogous motion of said moveable part for at
least part of the time during which at least one of said parameters
related to the medical, physiological, and/or emotional status of a
patient is within a predetermined set of values relative to a
predetermined set of boundary conditions.
[0026] It is a further object of this invention to disclose such a
device as disclosed in any of the above, further comprising a voice
recognition unit.
[0027] It is a further object of this invention to disclose such a
device, wherein said voice recognition unit is interfaced with said
means for transmitting a command signal to said physical therapy
device.
[0028] It is a further object of this invention to disclose such a
device, wherein said interface is adapted to perform, upon receipt
by said voice recognition unit of an appropriate vocal command, at
least one function chosen from the group consisting of (a) initiate
a therapy session; (b) terminate a therapy session; (c) override
said time-dependent command signals; (d) limit at least one motion
of said physical therapy device; (e) extend at least one motion of
said physical therapy device; and (f) any combination of the
above.
[0029] It is a further object of this invention to disclose such a
device as disclosed in any of the above, further comprising means
for determining in real time the position and orientation of the
body of a patient or at least one part thereof, said means chosen
from the group consisting of (i) a camera system adapted for
determining and reporting in real time the 3D position and
orientation of an object such that said determination is provided
by means of image processing; and, (ii) a plurality of sensors
adapted to measure and report their positions in real time attached
to said body of a patient or a part thereof, and/or to the movable
portion, and/or to the caregiver's hands while tailoring the
treatment course; wherein said time-dependent output signal is
proportional to the time-dependent position and orientation and
position of said body of a patient or a least one part thereof.
[0030] It is a further object of this invention to disclose such a
device, wherein at least one of said sensors are selected from a
group consisting of stereoscopic (3D) cameras adapted for motion
detection, image capture equipment adapted for tracking and
recording motion or any combination thereof.
[0031] It is a further object of this invention to disclose such a
device as disclosed in any of the above, wherein said motions are
selected from said allowed movements.
[0032] It is a further object of this invention to disclose such a
device as disclosed in any of the above, wherein said motions are
selected according to parameters characterizing said patient; said
parameters are selected from a group consisting of any combination
of physiological movements, in the sagittal (flexion-extension),
coronal (right and left lateral banding) and horizontal (right and
left rotation) planes of movement.
[0033] It is a further object of this invention to disclose a
method for controlling a physical therapy apparatus adapted for
receiving external commands, said method comprising steps of: (a)
obtaining the device as disclosed in any of the above; (b) moving
said moveable portion according to a predetermined protocol; (c)
measuring the time-dependent positions of said moveable portion
during the course of said predetermined protocol; (d) converting
said measurements to a time-dependent signal; (e) transmitting said
time-dependent signal to said transceiver; (f) storing said
time-dependent signal by using said storage means; (g) converting
said time-dependent signal to a time-dependent command signal; and
(h) transmitting said time-dependent command signal to said
physical therapy apparatus. It is within the essence of the
invention wherein moving said moveable portion causes said physical
therapy apparatus to undergo a series of motions substantially
identical to those of said moveable portion.
[0034] It is a further object of this invention to disclose such a
method, further comprising additional steps of: (i) recalling said
time-dependent signal from said storage means; (j) converting said
recalled time-dependent signal to a time-dependent command signal;
(k) transmitting said time-dependent command signal to said
physical therapy apparatus; and, (l) repeating steps (i) through
(k) a predetermined number of times.
[0035] It is a further object of this invention to disclose such a
method, additionally comprising step of maintaining said patient in
a predetermined position on a treatment table. It is a further
object of this invention to disclose a method for controlling a
physical therapy apparatus adapted for transmitting at least one
signal proportional to its orientation and further adapted for
receiving external commands, said method comprising steps of: (a)
manually altering the orientation of said physical therapy
apparatus according to a predetermined protocol; (b) transmitting,
during the course of said predetermined protocol, at least one
time-dependent signal proportional to the orientation of said
physical therapy apparatus to a storage device adapted for storing
time-dependent signals; (c) storing said at least one transmitted
time-dependent signal in said storage device; (d) recalling said
time-dependent signal from said storage device; (e) converting said
recalled time-dependent signal to a time-dependent command signal;
(f) transmitting said time-dependent command signal to said
physical therapy apparatus; and (g) repeating steps (d) through (f)
a predetermined number of times. It is within the essence of the
invention wherein transmitting said command signal causes said
physical therapy apparatus to undergo substantially the same
motions produced by said predetermined protocol.
[0036] It is a further object of this invention to disclose such a
method, comprising the additional step of placing at least one body
part in a position such that said alterations in the orientation of
said physical therapy apparatus will manipulate said at least one
body part according to a predetermined protocol.
[0037] It is a further object of this invention to disclose such a
method, wherein said additional step of placing at least one body
part in a position such that said alterations in the orientation of
said physical therapy apparatus will manipulate said at least one
body part according to a predetermined protocol occurs after step
(c) and prior to step (d).
[0038] It is a further object of this invention to disclose such a
method, additionally comprising step of maintaining said patient in
a predetermined position on a treatment table.
[0039] It is a further object of this invention to disclose a
method for controlling a physical therapy apparatus adapted for
receiving external commands, said method comprising steps of: (a)
obtaining an apparatus adapted for determining the time-dependent
position and orientation of at least one body part of a subject and
further adapted for transmitting a time-dependent signal
proportional to said time-dependent position and orientation; (b)
altering the position of said at least one body part according to a
predetermined protocol; (c) measuring the time-dependent position
and orientation of said at least one body part using said apparatus
during the performance of said predetermined protocol; (d)
transmitting a time-dependent signal proportional to the
time-dependent position and orientation of said at least one body
part during the performance of said predetermined protocol from
said apparatus to a storage device; (e) recalling said
time-dependent signal from said storage device; (f) converting said
time-dependent signal to a time-dependent command signal; (g)
transmitting said time-dependent command signal to said physical
therapy apparatus; and (h) repeating steps (e) through (g) a
predetermined number of times. It is within the essence of the
invention wherein said command signal produces a series of
alterations of the orientation of said physical therapy apparatus
substantially identical to those necessary to manipulate the
position and orientation of said at least one body part according
to said predetermined protocol.
[0040] It is a further object of this invention to disclose such a
method, wherein said step of obtaining an apparatus adapted for
determining the time-dependent position and orientation of at least
one body part of a subject and further adapted for transmitting a
time-dependent signal proportional to said time-dependent position
and orientation further includes a step of obtaining a camera
system adapted for determining and reporting in real time the 3D
position and orientation of an object by means of image
processing.
[0041] It is a further object of this invention to disclose such a
method, wherein said step of obtaining an apparatus adapted for
determining the time-dependent position and orientation of at least
one body part of a subject and further adapted for transmitting a
time-dependent signal proportional to said time-dependent position
and orientation further includes the additional steps of (a)
obtaining a plurality of sensors adapted to measure and report
their positions in real time; and (b) attaching said plurality of
sensors to said at least one body part of a subject.
[0042] It is a further object of this invention to disclose such a
method, additionally comprising step of maintaining said patient in
a predetermined position on a treatment table.
[0043] It is a further object of this invention to disclose such a
method, wherein at least one of said sensors are selected from a
group consisting of stereoscopic (3D) cameras adapted for motion
detection, image capture equipment adapted for tracking and
recording motion or any combination thereof.
[0044] It is a further object of this invention to disclose such a
method as disclosed in any of the above, further comprising the
additional steps of: (a) measuring at least one parameter related
to the medical, physiological, and/or emotional status of a
patient; (b) reporting said at least one parameter related to the
medical, physiological, and/or emotional status of a patient; and
(c) limiting by a predetermined amount at least one motion of said
physical therapy device to a value lower than the analogous motion
of said moveable part for at least part of the time during which at
least one of said parameters related to the medical, physiological,
and/or emotional status of a patient is within a predetermined set
of values relative to a predetermined set of boundary
conditions.
[0045] It is a further object of this invention to disclose such a
method as disclosed in any of the above, further comprising the
additional steps of: (a) measuring at least one parameter related
to the medical, physiological, and/or emotional status of a
patient; (b) reporting said at least one parameter related to the
medical, physiological, and/or emotional status of a patient; (c)
limiting by a predetermined amount at least one motion of said
physical therapy device to a value lower than the analogous motion
of said moveable part for at least part of the time during which at
least one of said parameters related to the medical, physiological,
and/or emotional status of a patient is within a predetermined set
of values relative to a predetermined set of boundary conditions;
and (d) increasing by a predetermined amount at least one motion of
said physical therapy device above the value of the analogous
motion of said moveable part for at least part of the time during
which at least one of said parameters related to the medical,
physiological, and/or emotional status of a patient is within a
predetermined set of values relative to a predetermined set of
boundary conditions.
[0046] It is a further object of this invention to disclose such a
method as disclosed in any of the above, further comprising the
additional steps of: (a) obtaining a voice recognition unit; (b)
interfacing said voice recognition unit with said means for
transmitting a command signal to said physical therapy device; (c)
receiving a vocal command; (d) performing at least one function
chosen from the group consisting of (i) initiate a therapy session;
(ii) terminate a therapy session; (iii) override said
time-dependent command signals; (iv) limit at least one motion of
said physical therapy device; (v) extend at least one motion of
said physical therapy device; and (vi) any combination of the
above.
[0047] It is a further object of this invention to disclose such a
method as disclosed in any of the above, further comprising the
additional step of playing music during at least a portion of the
time that said physical therapy apparatus is in use.
[0048] It is a further object of this invention to disclose such a
method as disclosed in any of the above, further comprising the
additional step of displaying a virtual reality simulation during
at least a portion of the time that said physical therapy apparatus
is in use.
[0049] It is a further object of this invention to disclose such a
method as disclosed in any of the above, further comprising the
additional step of maintaining said patient in a predetermined
position on a treatment table.
[0050] It is a further object of this invention to disclose an
apparatus for treating the body of a patient or a part thereof (the
treated part), by controllably maneuvering said treated part, said
apparatus comprising: (a) a cradle adapted for holding said treated
part stably and comfortably; and (b) a maneuverable platform upon
which said cradle rests, comprising maneuvering means adapted for
rotating the platform in the sagittal, coronal, horizontal planes
or in any combination of the planes thereof for a predetermined
duration. It is within the essence of the invention wherein said
maneuver of said part is characterized by parameters selected from
a predetermined set of allowed movements. Furthermore, a series of
command signals are produced by the movement of said moveable
portion, which, when transmitted to said physical therapy
apparatus, will cause said physical therapy apparatus to undergo a
series of motions substantially identical to those of said moveable
portion
[0051] It is a further object of this invention to disclose such an
apparatus, wherein at least one of said sensors are selected from a
group consisting of stereoscopic (3D) cameras adapted for motion
detection, image capture equipment adapted for tracking and
recording motion or any combination thereof.
[0052] It is a further object of this invention to disclose such an
apparatus, additionally comprising means adapted to maintain said
patient in a predetermined position on a treatment table.
[0053] It is a further object of this invention to disclose such an
apparatus, wherein said treated part is chosen from the group
consisting of (a) head, (b) neck, (c) any combination of the
above.
[0054] It is a further object of this invention to disclose such an
apparatus, wherein said treated part is maneuvered in a lobular
three dimensional manner.
[0055] It is a further object of this invention to disclose such an
apparatus, additionally comprising processing means for either
online or offline controlling or determining said parameters.
[0056] It is a further object of this invention to disclose such an
apparatus, further comprising means for presenting audiovisual
entertainment during the use of said apparatus, said means for
presenting audiovisual entertainment chosen from the group
consisting of (a) means for playing music during the treatment, (b)
means for presenting a virtual reality display.
[0057] It is a further object of this invention to disclose such an
apparatus, additionally comprising detecting means and reporting
means chosen from the group consisting of EMG, EKG, GSR or a
combination thereof, said detecting means and reporting means
adapted to obtain one or more parameters related to the medical,
physiological, and/or emotional condition of said patient; said
reporting means further adapted for either online or offline
reporting of said condition of said patient, and said reporting
means adapted to provide a report to at least one of (a) a remote
module, (b) an adjacent module.
[0058] It is a further object of this invention to disclose such an
apparatus, wherein said at least one detecting means is feedback
interconnected with said maneuverable platform such that at least a
portion of said maneuvering parameters is updated in a manner
chosen from the group consisting of (a) online and (b) offline.
[0059] It is a further object of this invention to disclose a
method for treating the body of a patient or a part thereof (the
treated part), comprising the steps of: (a) placing said treated
part on a manipulatable cradle; (b) controllably maneuvering said
cradle, either in a direct or indirect manner, in the sagittal,
coronal, horizontal planes or in any combination thereof for a
predetermined duration. It is within the essence of the invention
wherein said maneuvering is characterized by parameters selected
from a predetermined set of allowed movements.
[0060] It is a further object of this invention to disclose such a
method, further comprising the step of maneuvering said treated
part in a lobular three dimensional manner.
[0061] It is a further object of this invention to disclose such a
method, further comprising at least one step of detecting the
condition of said patient or said treated part, said step of
detecting performed in a manner chosen from the group consisting of
(a) online and (b) offline, and said step of detecting performed
either prior to or contemporaneously with step (b).
[0062] It is a further object of this invention to disclose such a
method, wherein said detecting is provided by means of a method
chosen from the group comprising EMG, EKG, GSR or a combination
thereof.
[0063] It is a further object of this invention to disclose such a
method, further comprising the additional steps of (a)
interconnecting in a feedbacked manner said manipulatable cradle
with said detecting means; and (b) updating at least a portion of
said maneuvering parameters, in a manner chosen from the group
consisting of (a) online and (b) offline, said step of updating
performed either prior to or contemporaneously with step (b).
[0064] It is a further object of this invention to disclose such a
method, adapted for treating at least one condition chosen from the
group comprising (a) headaches, (b) migraines, (c) myofascial
headaches, (d) muscular tension, (e) nervous tension, and (f) post
traumatic pain.
[0065] It is a further object of this invention to disclose such a
method, further adapted for treating neck pain.
[0066] It is a further object of this invention to disclose such a
method, wherein said neck pain is chosen from the group consisting
of (a) whiplash, (b) muscular pain, (c) cervical disc
herniation/protrusion associated with neck and arm pain, (d)
over-tension of the neck muscles, and (e) neck movement
disorders.
[0067] It is a further object of this invention to disclose such a
method, further adapted to achieve relaxation of the body parts
chosen from the group consisting of head, neck and shoulders.
[0068] It is a further object of this invention to disclose such a
method, further adapted to provide a treatment chosen from the
group consisting of (a) improvement of neck muscle function; (b)
treatment for at least one sleep disorder; (c) increasing neck
muscle bulk; (d) improving ROM; and (e) rehabilitating movement of
at least one affected body part following an injury.
[0069] It is a further object of this invention to disclose such a
method, further comprising an additional step of providing to said
patient a menu of different movement courses or cycles is provided,
wherein each of said movement courses or cycles is tailored for the
specific needs of patient with a particular set of symptoms.
[0070] It is a further object of this invention to disclose such a
method, further comprising the additional step of allowing said
cradle to move the head and neck of said patient to a predetermined
target, wherein the patient's motions are controlled by said
cradle.
[0071] It is a further object of this invention to disclose such a
method, further comprising the additional step of directing said
patient to react to the movement of said cradle by concomitant
movement of said patient's neck in substantially the same direction
as that of said cradle, wherein said patient actively controls his
or her own motions.
[0072] It is a further object of this invention to disclose a
method for decreasing the value of a patient's result according to
the Visual Analog Scale/Numerical (VAS/NRS) (10-point) Rating
Scale, comprising manipulating the body of said patient or part
thereof in a predetermined set of allowed movements, wherein said
VAS/NRS score decreases by at least 20%, when compared with a
control group which has not undergone said manipulations.
[0073] It is a further object of this invention to disclose a
method for increasing Functional health status SF-36 score of a
patient, comprising manipulating the body of said patient or a part
thereof in a predetermined set of allowed movements, wherein said
SF-36 is improved by at least 10%, when compared with a control
group which has not undergone said manipulations.
[0074] It is a further object of this invention to disclose a
method for decreasing a patient's Neck Disability Index (NDI),
comprising manipulating the body of said patient or a part thereof
in a predetermined set of allowed movements, wherein said NDI
decreases by at least 10% when compared with a control group which
has not undergone said manipulations.
[0075] It is a further object of this invention to disclose a
method for decreasing scores of at least one test selected from a
group consisting of (a) Headache Impact Test (HIT) and (b) Migraine
Disability Assessment Questionnaire (MIDAS), comprising a step of
manipulating the body of said patient or a part thereof in a
predetermined set of allowed movements, wherein said at least one
test score decreases in at least one stage, when compared with a
control group which has not undergone said manipulations.
[0076] It is a further object of this invention to disclose such a
method, wherein said Headache Impact Test is HIT-6.
[0077] It is a further object of this invention to disclose a
method for decreasing Epworth Sleepiness Scale (EPS), comprising
manipulating the body of said patient or a part thereof in a
predetermined set of allowed movements, wherein said EPS decreases
by at least 10% when compared with a control group which has not
undergone said manipulations.
[0078] It is a further object of this invention to disclose a
method for increasing (Short) Musculoskeletal Function Assessment
((S)MFA), comprising manipulating the body of said patient or a
part thereof in a predetermined set of allowed movements, wherein
said (S)MFA score increases in at least 10% when compared with a
control group which has not undergone said manipulations.
[0079] It is a further object of this invention to disclose a
method for decreasing a test score for a test of a patient's
ability to undertake daily activities, said test score according to
a scale in which 10=no ability to undertake daily activities and
0=full ability to undertake daily activities, comprising a step of
manipulating the body of said patient or a part thereof in a
predetermined set of allowed movements, wherein said at test score
decreases by at least 10%, when compared with a control group which
has not undergone said manipulations.
[0080] It is a further object of this invention to disclose a
method for increasing a patient's cervical range of motion,
comprising a step of manipulating the body of said patient or a
part thereof in a predetermined set of allowed movements, wherein
said patient's range of motion in at least one degree of freedom of
cervical motion increases by at least 10%.
[0081] It is a further object of this invention to disclose a
method for increasing the SF-36 (functional health status) score of
a patient, comprising a step of manipulating the body of said
patient or a part thereof in a predetermined set of allowed
movements, wherein said patient's SF-36 questionnaire score
increases by at least 10%.
[0082] It is a further object of this invention to disclose a
method for decreasing the Migraine Disability Assessment
Questionnaire score (MIDAS) of a patient, comprising a step of
manipulating the body of said patient or a part thereof in a
predetermined set of allowed movements, wherein said patient's
MIDAS decreases by at least 10%.
[0083] It is a further object of this invention to disclose a
method for decreasing the Epworth Sleepiness Scale (EPS) score of a
patient, comprising a step of manipulating the body of said patient
or a part thereof in a predetermined set of allowed movements,
wherein said patient's EPS score decreases by at least 10%.
BRIEF DESCRIPTION OF THE FIGURES
[0084] In order to understand the invention and to see how it may
be implemented in practice, a plurality of embodiments is adapted
to now be described, by way of non-limiting example only, with
reference to the accompanying drawings, in which
[0085] FIGS. 1a-1c is a schematic representation of a remote
control device adapted for use with a device for manipulating a
patient's head and neck;
[0086] FIG. 2 shows the remote control device of FIG. 1 in relation
to the physical therapy apparatus;
[0087] FIG. 3 schematically presents various possible rotations of
the head about the 101 sagittal, 102 coronal, and 103 horizontal
planes;
[0088] FIG. 4a illustrates an embodiment of the invention including
cradle 201, partially filled with viscous fluid, platform 202
supporting the cradle and moved by motors in three planes, and EMG
electrodes 203, used for research purposes, to determine the
optimal course of treatment;
[0089] FIG. 4b illustrates a device according to one embodiment of
the invention, wherein 1, 2, 3 and 4 are denoted for the standard
treatment table (upon which the person undergoing treatment rests
on), portable base, motion system and cradle members of the device,
respectively;
[0090] FIG. 5 illustrates cradle 201 according to one embodiment of
the present invention;
[0091] FIG. 6 schematically illustrates an embodiment of the
invention showing the two motors 301 (Horizontal) and 302 (Coronal)
and two linear actuators 303, and 304 (Sagittal) which move the
Cradle 305, in the three planes;
[0092] FIG. 7 illustrates, not to scale, various lobular two and
three dimensional maneuvers according to a set of possible
embodiment of the present invention; FIG. 3 sketches the 3 planes
of head and neck movement, together with the 3 axes of movement;
FIG. 7a illustrates a typical physiotherapy maneuver, 3D octet-like
course; FIGS. 7b to 7c represent various sets of various maneuvers
made by a plurality of allowed movements of the head and neck of
the present invention;
[0093] FIG. 8 illustrates EMG results in healthy and sick patients,
respectively, before, during and after treatment by the device and
methods of the invention; and
[0094] FIG. 9 presents preliminary results from a pilot study of
the present invention.
[0095] FIG. 10 illustrates another embodiment of the present
invention.
[0096] FIGS. 11-16 illustrate embodiments for the `holding` of the
patient's head and neck to a treatment table.
[0097] FIGS. 17-18 which illustrate another embodiment of the
present invention.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0098] In the following description, various aspects of the
invention will be described. For the purposes of explanation,
specific details are set forth in order to provide a thorough
understanding of the invention. It will be apparent to one skilled
in the art that there are other embodiments of the invention that
differ in details without affecting the essential nature thereof.
Therefore the invention is not limited by that which is illustrated
in the figures and described in the specification, but only as
indicated in the accompanying claims, with the proper scope
determined only by the broadest interpretation of said claims. As
used herein, the term "physical therapy device" refers to any
device that performs any kind of physical manipulation on the body
of an individual or a part thereof.
[0099] As used herein, the term "physical therapy session" refers
to a period of time during which a physical therapy device as
defined above is in operation (i.e. performing a physical
manipulation on the body of an individual or part thereof.
[0100] As used herein, the term "motion of a physical therapy
device" refers to the motions of said device that enable or cause
manipulation of the patient's body or body part of interest during
the physical therapy, and not necessarily to gross motions of the
device itself. Similarly, as used herein, terms such as "increase"
or "decrease" of the motion of a physical therapy device can refer
to changes in the amplitude, velocity, or acceleration of the
motions leading to the manipulation of the body or body part of
interest. That is, when the context requires it, it is understood
in what follows that the motions of the manipulated body or body
part are discussed in terms of the motions of the physical therapy
device that lead to such manipulations.
[0101] As used herein, the term "about" refers to a value being up
to .+-.25% of the defined measure.
[0102] As used herein, the term "EMG sensor" refers to a surface
electromyographic sensor, this being an electrical sensor adapted
for measurement of compound muscle action potential, which is
correlated to the degree of muscle activation.
[0103] As used herein, the term "cradle" refers to a supporting
means, selected in a non-limiting manner for cradles, pillows,
headrests, cushions, puffs, mattresses etc.
[0104] Reference is now made to FIG. 1, which illustrates an
embodiment of remote control device 400. In the embodiment
illustrated, the remote control device is adapted for controlling a
physical therapy device designed to perform manipulations of the
head and/or neck of a patient. The remote control device comprises
three sections: a moveable portion 401 (a glove-like element); a
motion manipulator portion 402; and a base portion 403. A schematic
illustration of the fully-assembled remote control device is given
in FIG. 1a.
[0105] Reference is now made to FIG. 1b, which provides a schematic
(not to scale) close-up view of moveable portion 401 and motion
manipulator portion 402. Moveable portion 401 is a glove-like
device into which the caregiver inserts his/her hands, and upon
which the patient's head and neck lie. The motion manipulator
portion comprises three individual manipulator units in order to
provide independent motion along each of the x, y, and z axes. Each
motion manipulator unit comprises a rod 4021 that is attached to,
and physically provides motion to, moveable portion 401. The rod is
attached to a position potentiometer 4022 that measures the
position of and controls the motion of the particular rod to which
it is connected. The details of motion control and measurement are
given below. The position potentiometer is attached to a ball joint
4023, allowing free movement in any direction. The ball joint rests
on ball joint base 4024.
[0106] Reference is now made to FIG. 1c, which provides a schematic
(not to scale) close-up view of base portion 403. The base
comprises an upper rest 4031, upon which motion manipulator portion
402 rests. Each of the ball joint bases 4024 is firmly affixed to
upper rest 4031. Base portion 403 further comprises a slider 4032.
The slider is adapted to raise or lower the moveable portion and
motion manipulator portion to the desired height appropriate to a
given individual being treated. Slider lock 4033 enables the user
to fix the height of the moveable portion once the proper height
has been established. The base portion further comprises a handle
4034, which is adapted to aid the user in manipulating the gross
position of the entire remote control unit. Base portion 403 rests
on a base 4035. Base 4035 further comprises a plurality of lockable
casters. In a preferred embodiment, the lockable casters are of a
type further comprising a swivel, thus enabling easy positioning of
the entire remote control unit.
[0107] This apparatus is connected to the physical therapy device
itself. Reference is now made to FIG. 2, which illustrates this
embodiment of the remote control device along with the physical
therapy device 4 that it controls. The moveable portion is attached
to one end of the motion manipulator portion. The attachment is
done by any means known in the art that allows the moveable portion
freedom of motion relative to the motion manipulator portion. In a
preferred embodiment, the moveable portion retains three rotational
degrees of freedom (i.e. freedom to rotate independently in the
sagittal, coronal, and horizontal planes; these planes of motion
are illustrated in FIG. 3) relative to the motion manipulator
portion. In a second preferred embodiment, the moveable portion
retains these three rotational degrees of freedom along with three
linear degrees of freedom (i.e. freedom to move independently along
the axis parallel to the motion manipulator part's primary axis of
the motion manipulator and the two axes in the plane perpendicular
to the motion manipulator part's primary axis).
[0108] Motion manipulator portion 402 further comprises means for
allowing the free motion of the moveable portion as described
above. Such means are well-known to those skilled in the art. In
addition, the motion manipulator portion comprises a plurality of
sensors for determining the motions of the moveable portion
relative to primary axis of the motion manipulator portion. These
sensors may be of any type known in the art (e.g. linear position
sensors) that is or can be adapted for transmitting in real time
measurements of the motions of the moveable portion, in particular,
the direction of motion, velocity, and acceleration along each of
the degrees of freedom. The sensors are adapted to convert these
measurements into time-dependent output signals, with the
magnitudes signals being proportional to the magnitudes of the
measured motions. Each of these signals is transmitted in real time
to a transceiver.
[0109] It is a further object of this invention to disclose such a
device, wherein at least one of said sensors are selected from a
group consisting of stereoscopic (3D) cameras adapted for motion
detection, image capture equipment adapted for tracking and
recording motion or any combination thereof.
[0110] In a preferred embodiment, this transceiver is a computer
board (pcb) located within a computer. Such boards, adapted for
recording the time-dependent output of motion or position sensors,
are well-known in the art, and any commercially available board of
this type that has a sufficient number of inputs to be able to
measure independently all of the signals output by the various
sensors may be used. The transceiver then transmits the signals
that it receives from the sensors to a storage unit. In preferred
embodiments, this storage unit is any digital storage means
convenient to the operator (e.g. the hard disk of a computer,
CD-ROM, etc.), and in embodiments in which the output of the
sensors is an analog signal, the analog-to-digital conversion is
done by the transceiver. The control of the physical therapy device
can then be done in a variety of fashions. In preferred
embodiments, the signals are retrieved from storage and then
transmitted as a time-dependent "command signal" to the physical
therapy device; this transmission can be done by the same
transceiver that is used to receive the time-dependent output
signals from the sensors (including digital-to-analog conversion if
necessary). The command signal is of an appropriate magnitude and
duration that when it is received by the controllers of the
physical therapy device, the device will reproduce the magnitudes,
durations, velocities, and accelerations of the original motions of
the moveable portion. The command signal is then transmitted to the
physical therapy device. Thus, a series of manipulations of the
moveable portion of the remote control device leads to identical
motions of the physical therapy device for manipulation of the body
or a part thereof of a patient. All of the means of signal
transmission and reception can be any of those that are known in
the art, whether hardwired (e.g. electrical signals) or
wireless.
[0111] It is a further object of this invention to disclose such a
device, wherein at least one of said sensors are selected from a
group consisting of stereoscopic (3D) cameras adapted for motion
detection, image capture equipment adapted for tracking and
recording motion or any combination thereof.
[0112] In a preferred embodiment of the invention, a computer is
provided that includes the control hardware and storage media
described above along with appropriate software to allow monitoring
and control of the apparatus and device. Such software allows the
operator to design or alter the protocol of motions of the physical
therapy device by direct input of commands that are then translated
into appropriate command signals.
[0113] Furthermore, since the time-dependent signals are stored
using a digital storage medium, a separate individualized protocol
can be stored and then recalled for each patient. In other words,
each patient is treated with a specific therapy such that each
therapy will be suited to said specific patient according to
different parameters characterizing said specific patient. said
parameters can be any combination of "allowed movements" as defined
in Table 1 below.
[0114] For many physical therapy applications, the manipulations of
the patient's body are done repetitively. The software allows the
operator to fix a specific number of repetitions that are to be
used in a particular physical therapy session, or to allow an
indefinite number of repetitions (e.g. until a STOP signal is
received). In addition, the caregiver can change the velocity and
amplitude of the recorded session, using a "coefficient" function,
to increase or decrease the speed or ROM of the treatment
session.
[0115] Additional embodiments allow for feedback control of the
physical therapy session. In these embodiments, the device
additionally includes a means for measuring and reporting at least
one parameter related to the medical, physiological, and/or
emotional status of a patient, chosen from the many commercially
available devices. Typical non-limiting examples of these
parameters include EMG, ROM, blood pressure, EKG, and galvanic skin
response (GSR). The measured parameters are reported to at least
one module that can be either adjacent to or remote from the
physical therapy apparatus. The feedback system in embodiments that
include it includes an interface between the reporting means and
the means for transmitting command signals to the physical therapy
device. A set of boundary conditions of the parameter or parameters
of interest is defined. When the measured parameter is reported to
be outside the boundary conditions, at least one motion of the
physical therapy device are reduced from those defined by the
protocol described above; the amount of such reduction is
predefined by the operator either prior to or during the physical
therapy session. Optionally, a set of boundary conditions can be
set such that when the parameter or parameters of interest lie
within the boundary conditions, at least one motion of the physical
therapy device is increased by a predetermined amount from that
defined by the original protocol as defined above.
[0116] As a non-limiting example, galvanic skin response (GSR),
heart rate and blood pressure can be used as indications of the
level of stress of the patient, and the boundary conditions set as
a predefined maximum GSR, heart rate and maximum blood pressure
such that a stress condition is defined when one of them exceeds
the predefined maximum (or when both exceed the predefined maximum
simultaneously). When a stress condition is determined, the initial
protocol is overridden, and at least one motion of the physical
therapy device lowered by a predetermined amount (either an
absolute or a relative amount) until the GSR, heart rate and/or
blood pressure return to values below the maximum. The boundary
conditions need not be an upper limit; they can be defined as a
lower limit, as a range, or to exclude a range, depending on the
parameter used and the therapeutic goal.
[0117] In an additional embodiment of the invention, the device
includes a voice recognition unit. Such units are well-known in the
art, and any appropriate commercially available device can be used.
The voice recognition unit is programmed to recognize at least one
vocal command (e.g. a specific word such as "STOP," any
vocalization above a certain decibel level, etc.). The voice
recognition unit is interfaced with the means for transmitting the
command signal such that a function of the device is performed on
receipt of a vocal command. A non-limiting list of typical
functions includes: initiating a physical therapy session; stopping
a physical therapy session; overriding the command signals (e.g.
via a command to increase or decrease the motion of the physical
therapy apparatus); limiting at least one motion of the physical
therapy device; and extending at least one motion of the physical
therapy device.
[0118] In alternative embodiments of the invention, the protocol
for the motions of the physical therapy device that lead to
manipulation of the body or body part of the patient is obtained by
the use of a device that can determine in real time the changes in
its position and orientation. The patient is physically manipulated
(either away from the physical therapy device or in contact with
it) and the motions of the patient's body or body part are
recorded. These motions are transmitted to the remote control
device, and converted to command signals such that the motions of
the physical therapy device will mimic those of the motions of the
patient during the physical manipulation. One means for
accomplishing this procedure is the use of a camera system designed
to measure and report in real time the 3D position and orientation
of the patient's body or body part. Said orientation is provided by
means of image processing.
[0119] In alternative embodiments of the invention, the protocol
for the motions of the physical therapy device that lead to
manipulation of the body or body part of the patient is obtained by
direct manipulation of the physical therapy apparatus rather than
by use of a remote control device. In these embodiments, the
physical therapy apparatus includes a plurality of sensors of types
analogous to those discussed above for the remote control system.
The patient is placed in contact with the physical therapy
apparatus, and the appropriate manipulations are performed
manually. The sensors measure the motions in a manner analogous to
that of the measurements of the moveable portion of the remote
control device described above. The sensors embedded within the
physical therapy apparatus produce output signals that are
proportional to the motions of the physical therapy device itself.
These output signals are then transmitted to the transceiver, and
the remainder of the method proceeds as in the embodiments
comprising a remote control device as described above.
[0120] It is a further object of this invention to disclose such a
device, wherein at least one of said sensors are selected from a
group consisting of stereoscopic (3D) cameras adapted for motion
detection, image capture equipment adapted for tracking and
recording motion or any combination thereof.
[0121] A specific non-limiting example of a physical therapy
apparatus that can be adapted for use with the invention herein
disclosed is a physical therapy apparatus for treatment of the head
and/or neck.
[0122] In essence the proposed device is a computerized neck
mobilization device, which is controlled by muscle feedback. It
supports natural neck lordosis. The dynamic cradle is a
multi-layered pillow, which is filled with adjustable
flexible/liquid/viscous material. The person undergoing treatment
rests his or her head within a recess in the cradle while lying
down, either prone or supine. In the course of the treatment the
head is caused to perform a 3D oscillatory movement at a very slow
velocity (e.g., 0.3-3.degree. s.sup.-1) by means of motors adapted
to move a platform, on which the cradle rests, in three axes. This
slow movement is adapted to lengthen and relax over-contracted neck
muscles. It is adapted to gradually abolish abnormal neck muscle
contraction patterns.
[0123] A computer controls the movement of the motorized platform
upon which the cradle rests.
[0124] In one embodiment of the invention this computer provides
movement of the head described in the following table, in which the
angle of the head is defined by the vector of movement angles in
the sagittal, coronal, and horizontal planes, denoted (S, C, H),
where S is the sagittal angle in degrees, C is the coronal angle in
degrees, and H is the horizontal angle in degrees, and where in all
planes 0.degree. is the position of the un-tilted head:
TABLE-US-00001 TABLE 1 Basic Movement Cycle and Allowable Movements
Step Allowable Movement Start Angle End Angle 1. Sagittal flexion
(0.degree., 0.degree., 0.degree.) (Up to 70.degree., 0.degree.,
0.degree.) 2. Sagittal return (Up to 70.degree., 0.degree.,
0.degree.) (0.degree., 0.degree., 0.degree.) 3. Coronal tilt right
(0.degree., 0.degree., 0.degree.) (0.degree., Up to 45.degree.,
0.degree.) 4. Coronal return right (0.degree., Up to 45.degree.,
0.degree.) (0.degree., 0.degree., 0.degree.) 5. Coronal tilt left
(0.degree., 0.degree., 0.degree.) (0.degree., Up to -45.degree.,
0.degree.) 6. Coronal return left (0.degree., Up to -45.degree.,
0.degree.) (0.degree., 0.degree., 0.degree.) 7. Horizontal rotation
(0.degree., 0.degree., 0.degree.) (0.degree., 0.degree., Up to
60.degree.) right 8. Horizontal return right (0.degree., 0.degree.,
Up to 60.degree.) (0.degree., 0.degree., 0.degree.) 9. Horizontal
rotation left (0.degree., 0.degree., 0.degree.) (0.degree.,
0.degree., Up to -60.degree.) 10. Horizontal return left
(0.degree., 0.degree., Up to -60.degree.) (0.degree., 0.degree.,
0.degree.)
[0125] It is in the scope of the invention wherein the patient's
body or an organ thereof is manipulated in a set of (i) allowed
movement, (ii) start angles, and (iii) end angles; Sagittal
flexion, (0.degree., 0.degree., 0.degree.), (Up to 70.degree.,
0.degree., 0.degree.), respectively; Sagittal return (Up to
70.degree., 0.degree., 0.degree.), (0.degree., 0.degree.,
0.degree.; Coronal tilt right, (0.degree., 0.degree., 0.degree.),
(0.degree., Up to 45.degree.), 0.degree.; Coronal return right,
(0.degree., Up to 45.degree., 0.degree.), (0.degree., 0.degree.,
0.degree.); Coronal tilt left), (0.degree., 0.degree., 0.degree.),
(0.degree., Up to -45.degree., 0.degree.); Coronal return left,
(0.degree., Up to -45.degree., 0.degree.), (0.degree., 0.degree.,
0.degree.); Horizontal rotation right, (0.degree., 0.degree.,
0.degree.), (0.degree., 0.degree., Up to 60.degree.); Horizontal
return right, (0.degree., 0.degree., Up to 60.degree.), (0.degree.,
0.degree., 0.degree.); Horizontal rotation left, (0.degree.,
0.degree., 0.degree.), (0.degree., 0.degree., Up to -60.degree.);
Horizontal return left, (0.degree., 0.degree., Up to -60.degree.),
(0.degree., 0.degree., 0.degree., respectively, refers in the
present invention as "allowed movements".
[0126] In `feedback mode` the computer receives feedback signals
from electromyography (EMG) sensors on the patient's shoulder
girdle neck and/or facial muscles, to optimize a personal unique
treatment of the head and neck in three dimensional space and time.
The biofeedback uses EMG, involving electrodes which monitor the
compound active muscles action potential.
[0127] The pattern movement optimization of is established through
a mathematical algorithm. Once the following parameters: 3D diverse
positions, motion sequences, frequencies and movement timing are
optimized in all three planes; this data is stored for further
treatments.
[0128] Due to the technology used, the patient undergoes a relaxing
"zero gravity" floating experience, which leads to profound muscle
relaxation, including relaxation of neck muscles as well as facial
and mastication muscles.
[0129] This dynamic cradle is useful for the treatment of pain
especially head and neck pain syndromes such as migraine, and other
headaches: tension type, post traumatic, cervicogenic, and
myofascial headache, as well as neck pain, such as whiplash injury
and muscle over-contraction.
[0130] Moreover, this dynamic cradle is useful for the treatment of
ROM dysfunctions, by improving patient's ROM and neck muscle
flexibility; rehabilitation and relaxation of shoulder and neck
muscles over-contraction, e.g., after sport activity and/or other
injuries, and whole body relaxation. Besides, while opposing the
cradle movement one can increase his or her muscle bulk &
strength.
[0131] In one embodiment of the invention, vestibular physical
therapy is provided for treatment of patients with Benign
Paroxysmal Positional Vertigo.
[0132] In addition, this dynamic cradle is useful for treating
sleep disorders; and cervical disc-herniation/protrusion associated
with neck and arm pain and osteoarthritis coupled with arm pain.
According to one embodiment of the invention, it produces a
kneading action similar, but markedly superior to that achieved by
physical therapist neck mobilization.
[0133] According to yet another preferred embodiment of the present
invention, a cradle is provided that conforms to the shape of the
human head, neck and shoulders. The cradle rests upon a platform,
which in turn may be moved in three dimensions by a plurality of
motors. These motors are controlled by a computer actuating
electronics adapted to do so.
[0134] In another embodiment of the invention a series of
electromyographic sensors are used to provide feedback to the
computer algorithm controlling the cradle's movements. By means of
this feedback, movement of the motorized platform is optimized in
order to provide the maximum level of muscle relaxation as
indicated by the electromyographic signal.
[0135] It is a further object of this invention to disclose such a
device, wherein at least one of said sensors are selected from a
group consisting of stereoscopic (3D) cameras adapted for motion
detection, image capture equipment adapted for tracking and
recording motion or any combination thereof.
[0136] In another preferred embodiment of the invention, the
optimal 3D diverse positions, motion sequences, frequencies and
timing information gleaned from each individual feedback and saved
by the computer program for future use.
[0137] In another embodiment of the invention, GSR and EKG signals
are also used as feedback signals to inform operation of the
computer algorithm, and achieve relaxation parameters of the whole
body, and not only the treated areas.
[0138] In another embodiment of the invention, an additional
supporting cradle is provided for neck lordosis, which may be
separately adjustable.
[0139] In another preferred embodiment, the head is contained in a
depression of at least 10 by 10 centimeters, such that in motions
of rotation, flexion and lateral bending or tilting, the head is
adapted to not slip from its place and the motion due to a given
movement is adapted to therefore be predictable and repeatable.
[0140] In another preferred embodiment the platform
movement-frequency is adapted to be between about 0.03 Hertz to
about 0.2 Hertz.
[0141] In another preferred embodiment, the head tilt angle is
adapted to be fixed to an accuracy of 1 degree.
[0142] In another embodiment of the invention a Faraday cage is
adapted to be provided around the motor to eliminate any
interference between the motor and the electromyographic
sensors.
[0143] In another embodiment of the invention the user or operator
is able to limit the head lifting/manipulating angle by means of an
external switch.
[0144] In another preferred embodiment a preliminary test program
is performed on the subject, to determine the maximum motion angle
at each plane (See table 1) and any of the three planes combined
motions. The preliminary test mode allows the optimization of safe
and optimal treatment plan.
[0145] In another preferred embodiment a menu of different movement
courses or cycles is available, each tailored to deal most
effectively with a different type of patient.
[0146] In another preferred embodiment each plane is capable of
independent activation.
[0147] In additional embodiments of the invention, a menu of
different movement courses or cycles is provided, wherein each
movement course or cycle is tailored for the specific needs of
patients with a particular set of symptoms. In one of these
embodiments, the patient is asked to fully relax and allow the
device to move the head and neck to the predestined target. In this
embodiment, the patient is passive.
[0148] In another embodiment comprising such a menu, the patient is
asked to react to the device's movement by concomitant precise
movement of his neck in the same direction. In this embodiment, the
patient is active, and the device provides the opportunity for the
execution of different exercises. This type of utilization will
augment proprioceptive mechanisms, increase the neck muscle gross
motor strength, and restore proper neck posture and muscle
activation balance.
[0149] In another embodiment, the upper body may be raised by a
further part of the cradle to between about 15 and about 20
degrees.
[0150] In another embodiment of the invention, music is played
during the treatment.
[0151] In another embodiment of the invention, either 2D or 3D
virtual reality is played or displayed during at least portions of
the treatment.
[0152] In another embodiment of the invention, the cradle may be
heated or cooled.
[0153] In another embodiment of the invention, the platform upon
which the cradle rests is attached to the bed upon which the person
undergoing treatment rests.
[0154] Reference is now made to FIG. 5, which illustrates one
embodiment of cradle 201. A cradle cover 204, constructed from
flexible cloth, is fixed over the cradle. The neck of the patient
rests on cervical rest 205. The cervical rest includes an elastic
strap and is filled with small spheres of polystyrene or a similar
plastic in order to maximize the contact area between the patient's
body and the cradle, as well as to maximize the patient's comfort.
Cradle 201 further comprises an adjustable head strip 206. Head
strip 206 is affixed to the patient's head, and is adjustable to
match the size of the patient's head. In the embodiment
illustrated, the cradle further comprises a plurality of width
pockets 207 adapted to adjust the cradle to the width of the
patient's head. In some embodiments of the invention, the at least
one of the width pockets contains at least one oval pillow. As with
the cervical rest, the head strip and width pockets are designed to
maximize the contact between the patient's body and cradle 201 in
order to maximize the patient's comfort for a better treatment
experience.
[0155] The term "SF-36" was constructed to survey health status in
the Medical Outcomes Study, see for example in
http://www.mcw.edu/midas/health/SF-36.html. The SF-36 was designed
for use in clinical practice and research, health policy
evaluations, and general population surveys. The SF-36 includes one
multi-item scale that assesses eight health concepts: 1)
limitations in physical activities because of health problems; 2)
limitations in social activities because of physical or emotional
problems; 3) limitations in usual role activities because of
physical health problems; 4) bodily pain; 5) general mental health
(psychological distress and well-being); 6) limitations in usual
role activities because of emotional problems; 7) vitality (energy
and fatigue); and 8) general health perceptions. The survey was
constructed for self-administration by persons 14 years of age and
older, and for administration by a trained interviewer in person or
by telephone. The history of the development of the SF-36, the
origin of specific items, and the logic underlying their selection
are summarized. The content and features of the SF-36 are compared
with the 20-item Medical Outcomes Study short-form.
[0156] The term "Headache Impact Test (HIT)" is a tool used to
measure the impact headaches have on the ability to function on the
job, at school, at home and in social situations, see for example
in http://www.headachetest.com/HIT6/PDFS/English.pdf. The patient's
score shows the effect that headaches have on normal daily life and
on the ability to function. HIT was developed by an international
team of headache experts from neurology and primary care medicine
in collaboration with the psychometricians who developed the SF-36
health assessment tool. The term "HIT-6" is a short-form version of
the HIT, using just six items to capture the effect of headache and
its treatment on an individual's functional status and well-being
see for example in http://www.qualitymetric.com/products/hit6.aspx.
HIT-6 is useful both for screening and for monitoring change in
disease impact.
[0157] The term "Migraine Disability Assessment Questionnaire
(MIDAS)" is a questionnaire that measures headache-related
disability simply and easily by counting the number of days of lost
and limited activity due to migraine, see for example in
http://www.midas-migraine.net/edu/about.asp. Activities are classed
into three areas: (1) Paid work and education (school/college); (2)
Household work (unpaid work such as housework, shopping and caring
for children and others); (3) Family, social and leisure
activities. MIDAS was developed to improve migraine care by helping
physicians to identify sufferers most severely affected by their
migraine and, therefore, most in need of care. The MIDAS approach
increases the likelihood of patients receiving the right treatment,
the first time they visit their physician about migraine.
[0158] The term "Visual Analog Scale/Numerical Rating Scale
(VAS/NRS)" is a scale that helps patients describes their pain, see
for example in
http://www.nccn.org/patients/patient_gls/_english/_pain/2_assessment.asp.
The pain scale is commonly used to describe the intensity of the
pain or how much pain the patient is feeling. On the numerical
rating scale, the person is asked to identify how much pain they
are having by choosing a number from 0 (no pain) to 10 (the worst
pain imaginable). The visual analog scale is a straight line with
the left end of the line representing no pain and the right end of
the line representing the worst pain. Patients are asked to mark on
the line where they think their pain is.
[0159] The term "(Short) Musculoskeletal Function Assessment
((S)MFA)" evaluates the health status of patients with
musculoskeletal disorders of the extremities, including patients
with fractures and soft tissue injuries, repetitive motion
disorders, osteoarthritis or rheumatoid arthritis, see for example
http://www.ortho.umn.edu/img/assets/12487/instruc.doc. It describes
patient functioning, assesses outcomes of surgical interventions
and clinical trials, and monitors patients' functional status over
time
[0160] The term "Range of motion (ROM)" is a measurement of the
achievable distance between the flexed position and the extended
position of a particular joint or muscle group, see for example in
http://en.wikipedia.org/wiki/Range_of_motion. The act of attempting
to increase this distance through therapeutic exercises (range of
motion therapy--stretching from flexion to extension for
physiological gain) is also sometimes called range of motion. It is
in the scope of the invention wherein success is recorded by
improving of 10% in range of motion. Such an improvement is
recorded, e.g., by factorizing the five main movements: Sagittal
plane, Horizontal plane (left and right), and Coronal (left and
right) plane.
[0161] The term "Neck Disability Index (NDI)" is a questionnaire
that assesses the neck pain complaints, see for example in
http://www.painworld.zip.com.au/articles/tools/Neck%20
Disability%20Index.pdf. It is designed to enable the understanding
of how much the neck pain has affected the ability to manage
everyday activities.
[0162] The term "Epworth Sleepiness Scale (EPS)" is a scale which
is used to determine the level of daytime sleepiness, see for
example in http://www.umm.edu/sleep/epworth_sleep.html. A score of
10 or more is considered sleepy. A score of 18 or more is very
sleepy. If you score 10 or more on this test, you should consider
whether you are obtaining adequate sleep, need to improve your
sleep hygiene and/or need to see a sleep specialist.
[0163] Reference is now made to FIGS. 7a to 7f, illustrating, not
to scale, the direction in which the treated organ is maneuvered.
FIG. 7a illustrates an even figure 8-like track (here, a clockwise
direction). This lobular maneuver is provided in a two dimensional
and/or a three dimensional manner here a loop-like continuous
movement along the sagittal plane. FIG. 7b depicts similar figure
8-like track, here, along a counter-clockwise direction. FIGS.
7c-7f depict similar figure 8-like continuous movement along
various planes. It is acknowledged in this respect that uneven
figure 8-like (with one extended lob) continuous movements along
all Sagittal, Horizontal, and Coronal planes are possible.
[0164] This 2D and/or 3D maneuver is provided in a continuous or
interrupted manner, in a spontaneous, feedbacked and/or
predetermined manner. It is in the scope of the invention wherein
the aforesaid 3D movement is provided with six degrees of freedom
(DFs), especially wherein the motion is characterized by a
continuous passive motion in a 6-DFs lobular maneuver.
[0165] Reference is now made to FIGS. 8a and 8b, presenting
examples of EMG results in a control patient (a healthy female aged
30 years) and an 85 year old male patient with tension type
headaches (TTH), respectively. EMG values increase at the initial
10 minutes of resting the head on a cradle (see member 201 above).
By actuating the maneuverable platform upon which the cradle rests,
by maneuvering the head of the patient in the sagittal plane in a
set of allowed movements, EMG values significantly decreased from
low value (2.5 .mu.V) to even lower values (1.2 .mu.V, 50%
reduction for healthy control patient, FIG. 5a); and dramatically
decreased in the TTH patient from very high values (350 .mu.V) to
lower values (250 .mu.V, 30% reduction), respectively. Moreover,
short-time after treatment effect is detected, see for example
reduction of EMG from about 275 .mu.V (25 min) at the termination
of the treatment, to about 250 .mu.V, 10 minutes after treatment
has stopped. Similarly, a long-term treatment was obtained.
[0166] It is in the scope of the invention wherein the treatment is
provided in which the patient is laying in a relaxed manner,
wherein minimal muscle tension (especially head and shoulder
muscles) is provided.
[0167] It is also in the scope of the invention wherein the
treatment is provided while (i) specific physiological data, e.g.,
EMG and ROM; and (ii) non-specific data, e.g., blood pressure, EKG
(aka ECG; e.g., heartbeat and beat to beat variability), galvanic
skin response (GSR), is collected.
[0168] It is in the scope of the invention wherein the device and
methods thereof are especially adapted for domestic or other
out-of-clinic treatments.
[0169] It is still in the scope of the invention wherein the device
is especially adapted to be provided with a `learning mode`, such
that the caregiver and/or patient inputs parameters related to the
maneuvers. The input is provided orally, physically (e.g., by
utilizing caregiver's hands) or any other method.
[0170] It is lastly in the scope of the invention wherein the
device is operated to reduce blood pressure (systole and/or
diastole blood pressure), e.g., in 10% or more in respect to the
pretreatment basal level.
Example
[0171] As an example of the effectiveness of the invention herein
disclosed, results of a pilot study using the invention are
presented. This study was performed using an embodiment of the
invention in which the protocol of motions of the physical therapy
apparatus was set by using the remote control device described
above, and the physical therapy device comprised the cradle
described above to treat head and neck pain.
[0172] For the pilot study, performed at Bnai Zion Medical Center
in Haifa, Israel, 12 patients suffering from chronic neck pain were
recruited, 10 of whom completed the study. The treatment comprised
2 treatment sessions per week for 6 weeks. The manipulation
protocol consisted of 20 minutes of repetitive flexion/extension
oscillations in the sagittal plane at velocities of 0.5-2.degree.
s.sup.-1 through an angle of between 15 and 40.degree.; the
velocity used and angle through which the manipulations were
carried out were chosen according to the specific needs of the
individual patient. Measurements were made of the Cervical Range of
Motion (CROM), pain threshold trigger points (Algometry),
physiological data including EMG, EKG, and GSR, and validated
questionnaires: the visual analog pain scale (VAS), Neck Disability
Index (NDI), quality of life (SF-36). Other specially-designed
questionnaires included: Daily Activities, device Comfort and
general Satisfaction.
[0173] No adverse effects of the treatment were reported; indeed,
the protocol was sufficiently relaxing that some of the patients
fell asleep during the physical therapy sessions. EMG recordings
showed reduced bilateral activity of the trapezius muscle during
the treatment. GSR data showed a significant reduction in skin
conductance during the treatment, indicating marked relaxation.
There was a decrease in the pain sensitivity at the trigger points
as well as a significant increase in the CROM. NDI results show a
significant reduction in disability.
[0174] Of the 10 patients who completed the study, only one showed
no improvement at all. Two showed complete remission of pain with
no recurrence of pain within hours of the treatment, while six
reported a response of "good," "very good," or "excellent." Thus, a
significantly positive outcome was observed for 8 out of 10 of the
patients who completed the study, demonstrating the efficacy of the
invention herein disclosed.
[0175] Reference is now made to FIG. 9, which presents graphically
selected results from the pilot study described in the present
example. FIG. 9a shows results for cervical range of motion (CROM)
for six different movements. Of the six movements that were
measured (flexion, extension, lateral bending to the right and to
the left, and rotation to the right and to the left), statistically
significant improvement (P<0.05) was seen in extension (from an
average of 47.8.degree. to an average of 59.3.degree.) and leftward
rotation (from an average of 59.8.degree. to an average of
68.3.degree.). A statistical analysis of the entire test (all six
motions) shows that the invention herein disclosed provides
statistically significant overall improvement in cervical motion
(p=0.034).
[0176] FIG. 9b shows results for algometry. Statistically
significant improvement was seen in the muscle strength for all of
the relevant muscles (p=0.073 for week 6 vs. week 1).
[0177] FIG. 9c shows results for the VAS. On this scale,
10=unbearable pain and 0=no pain at all. As can be seen in the
figure, the average VAS level decreased from 5.7 to 4.35, an
improvement of 24%. The efficacy of the method disclosed in the
present invention for enabling those treated to return to their
normal daily activities is illustrated in FIG. 9d. On this scale,
10=cannot function at all, while 0=fully functioning. As shown in
the figure, during the course of treatment, the average ability to
undergo daily activities increased by nearly 40% (from 4.2 to 2.5).
This increase is statistically significant (p=0.033).
[0178] Results from the NDI and SF-36 questionnaires are shown in
FIGS. 9e and 9f, respectively. As can be seen in the figures, the
patients' own reports of how their neck pain affected their
day-to-day activities and the state of their health showed
significant improvement in all categories, e.g. p=0.049 for week 8
vs. week 1 NDI.
[0179] Finally, FIG. 9g shows that the patients reported an
increase in their comfort following the use of the invention
disclosed herein, and that all would wish to use it again should
the need arise. Reference is now made to FIG. 10, which illustrates
an embodiment of remote control device 700. In the embodiment
illustrated, the remote control device is adapted for controlling a
physical therapy device designed to perform manipulations of the
head and/or neck of a patient. The remote control device comprises
5 sections: a motorized platform 701 (e.g. hexapod); a customized
adjustable head and neck cradle 702; Caregiver control unit, which
enables the practitioner to define and control the treatment
sessions 703; T&R (teach & repeat) sensors or cameras,
capable of tracking and recording head movements as conducted by
the practitioner (Teach phase). 704; and customized, height and
inclination adjusted, treatment table 705.
[0180] The device allows the caregiver to tailor specific sequences
of motion courses, defining range of motion, velocity and
acceleration, to match the patient's needs. Such means are
well-known to those skilled in the art. In addition, the motion
manipulator portion comprises a plurality of sensors for
determining the motions of the moveable portion relative to primary
axis of the motion manipulator portion. These sensors may be of any
type known in the art (e.g. linear position sensors) that is or can
be adapted for transmitting in real time measurements of the
motions of the moveable portion, in particular, the direction of
motion, velocity, and acceleration along each of the degrees of
freedom. The sensors are adapted to convert these measurements into
time-dependent output signals, with the magnitudes signals being
proportional to the magnitudes of the measured motions. Each of
these signals is transmitted in real time to a transceiver.
[0181] In a preferred embodiment, this transceiver is a computer
board (pcb) connected to caregiver control unit (703). Such boards,
adapted for recording the time-dependent output of motion or
position sensors, are well-known in the art, and any commercially
available board of this type that has a sufficient number of inputs
to be able to measure independently all of the signals output by
the various sensors may be used. The transceiver then transmits the
signals that it receives from the sensors to a storage unit. In
preferred embodiments, this storage unit is any digital storage
means convenient to the operator (e.g. the hard disk of a computer,
CD-ROM, etc.), and in embodiments in which the output of the
sensors is an analog signal, the analog-to-digital conversion is
done by the transceiver. The control of the physical therapy device
can then be done in a variety of fashions. In preferred
embodiments, the signals are retrieved from storage and then
transmitted as a time-dependent "command signal" to the physical
therapy device; this transmission can be done by the same
transceiver that is used to receive the time-dependent output
signals from the sensors (including digital-to-analog conversion if
necessary). The command signal is of an appropriate magnitude and
duration that when it is received by the controllers of the
physical therapy device, the device will reproduce the magnitudes,
durations, velocities, and accelerations of the original motions of
the moveable portion. The command signal is then transmitted to the
physical therapy device. Thus, a series of manipulations of the
moveable portion of the device leads to identical motions of the
physical therapy device for manipulation of the body or a part
thereof of a patient. All of the means of signal transmission and
reception can be any of those that are known in the art, whether
hardwired (e.g. electrical signals) or wireless.
[0182] It is a further object of this invention to disclose such a
device, wherein at least one of said sensors are selected from a
group consisting of stereoscopic (3D) cameras adapted for motion
detection, image capture equipment adapted for tracking and
recording motion or any combination thereof.
[0183] According to another embodiment of the present invention a
variety of embodiment are provided for illustrating the holding and
attachment of the patient's head and neck to the treatment
table.
[0184] Reference is now made to FIGS. 11-12 which illustrate one
embodiment 500 for ensuring the stable `holding` of the patient's
head and neck to the treatment table 501.
[0185] According to this embodiment, `headphone`-like or
`earphone`-like element 502 are provided. According to this
embodiment, said element 502 is coupled to the treatment table 501
once patient puts the same and lays on the treatment table 501.
[0186] Said coupling ensure the correct positioning of the patient
and maintenance of said patient in the same position.
[0187] Reference is now made to FIGS. 13-14 which illustrate
another embodiment for the `holding` of the patient's head and neck
to the treatment table 501.
[0188] According to this embodiment strip-like element 503 to be
coupled to the patient's head and to the treatment table 501 so as
to maintain the patient in position.
[0189] Reference is now made to FIGS. 15-16 which illustrate
another embodiment for the `holding` of the patient's head and neck
to the treatment table 501.
[0190] According to this embodiment, again, `headphone`-like or
`earphone`-like element 504 are provided. Said element 504
comprises at least one coupling member 505 to be, eventually,
connected to the distal end 506 of the treatment table 501
[0191] As described above, the present invention provides a device
that, according to one embodiment, will be part of the one-piece
stand-alone device, and not a "joystick" or other separated tool
that will be beside the treatment table. Both Teach and Repeat
functions will be performed on the same unit.
[0192] Reference is now made to FIGS. 17-18 which illustrate
another embodiment of the present invention.
[0193] In this embodiment, the moveable portion of the device
additionally comprises a sensor unit (180). The sensor unit (180)
comprises sensors to establish the position of the head in real
time during treatment. The sensors can be accelerometers,
inclinometers, gyroscopic, ultrasound sensors (namely, transmitter)
or any combination thereof.
[0194] It should be noted that the ultrasound transmitter, may,
according to one embodiment of the present invention protrude out
from the moveable portion's (or the sensors unit's) housing, see
numerical reference 1800.
[0195] In one embodiment, the position of the head is communicated
to display means, recording means and any combination thereof. In
another embodiment, the position of the head is communicated
relative to its position at some previous time.
[0196] According to this embodiment, the physician maneuvers the
head (or any other treated organ); the movement of the same is
recorded (by means of said sensors) and then the motion
manipulation portion of the device can repeat said movements
without the presence of the physician.
[0197] According to another embodiment of the present invention,
the sensor unit (180) is held firmly but comfortably to the head by
restraining means, preferably at least one strap (190), which is
adjustable, in a non-limiting manner, by means of one of a group
consisting of elasticity in at least one portion of the strap, a
ratchet, a pull adjustment locked by means of a friction buckle a
pull adjustment locked by means of a buckle with a tang, and any
combination thereof.
[0198] A single strap will preferably surround the head in the
transverse plane.
[0199] A pair of straps may surround the head with one tilted
upward from the transverse plane from the sensor unit (180) to near
the crown of the head, with the other tilted downward from the
transverse plane from the sensor unit (180) to near the base of the
head. In another embodiment, there is a transverse strap and a
spring-like portion fitting over the head in the sagittal
plane.
[0200] According to another embodiment of the present invention a
connector 191 for power & data transfer is also provided so as
to provide the sensor unit (180) with electrical power and for
transmitting the recorded data.
[0201] According to another embodiment, the connector 191 is a Mini
USB connector.
[0202] According to another embodiment of the present invention a
manual switch (192) in communication with the therapist's hand is
provided. Said manual switch (192) controls the system record and
hexapod moving.
[0203] Reference is now made to FIG. 18 which provides a closer
view of the manual switch (192).
[0204] According to one embodiment, the manual switch (192)
comprises a hexapod moving button 1921.
[0205] According to one embodiment, the manual switch (192)
comprises a system record (the "Teach") button 1922.
[0206] According to one embodiment, the manual switch (192)
comprises a ring-like button's holder, partial covered with
material (e.g. silicon) to improve grip 1923.
[0207] In the foregoing description, embodiments of the invention,
including preferred embodiments, have been presented for the
purpose of illustration and description. They are not intended to
be exhaustive or to limit the invention to the precise form
disclosed. Obvious modifications or variations are possible in
light of the above teachings. The embodiments were chosen and
described to provide the best illustration of the principals of the
invention and its practical application, and to enable one of
ordinary skill in the art to utilize the invention in various
embodiments and with various modifications as are suited to the
particular use contemplated. All such modifications and variations
are within the scope of the invention as determined by the appended
claims when interpreted in accordance with the breadth they are
fairly, legally, and equitably entitled.
* * * * *
References